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M/S 3 > Exam 2 - cardiac disorders > Flashcards

Exam 2 - cardiac disorders Flashcards

1
Q

what is cardiac tamponade (pericardial effusion)

A

accumulation of fluid in the pericardial sac

causes extreme pressure on the heart, prevents ventricles from fulling expanding

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2
Q

s/sx of cardiac tamponade (pericardia effusion)

A

CP
confusion
anxiety
restlessness
tachycardia (d/t low CO)
tachypnea (d/t low CO)
JVD
muffled heart sounds
narrow PP

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3
Q

Becks Triad r/t cardiac tamponade complications

A

low BP
muffled heart sounds
JVD

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4
Q

Becks Triad can lead to what emergency procedure

A

pericardiocentesis

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5
Q

what is cardiomyopathy

A

diseased heart muscle
heart is enlarged and thickened

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6
Q

what are the 3 types of cardiomyopathy

A

dilated
hypertrophic
restrictive

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7
Q

cardiomyopathy causes a ___ in pumping ability which leads to ___ ___; eventually leading to ___ backing up into the ___

A

decrease
heart failure
blood; lungs

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8
Q

most common type of cardiomyopathy

A

dilated

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9
Q

what occurs with dilated cardiomyopathy

A

ventricle dilation
impaired systolic function
enlarged atrium
blood stasis in L ventricle
diminished ctx of muscle fibers
myocardial cell necrosis

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10
Q

causes of dilated cardiomyopathy

A

pregnancy
HTN
alcohol abuse
viral infections
chemo meds
myexedema
persistent tachycardia
thyrotoxosis
Chagas disease

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11
Q

s/sx of dilatedcardiomyopathy

A

dyspnea at rest
orthopnea
N/V/A
crackles
edema
JVD
weak peripheral pulses
stasis, clots

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12
Q

s/sx of dilated cardiomyopathy as disease progresses

A

dry cough
palpitations
N/V/A
bloating

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13
Q

dilated cardiomyopathy treatment

A

tx underlying disease
HF
ventricular support device
transplant
home health
hospice

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14
Q

leading cause of dilated cardiomyopathy death

A

ventricular dysrhythmias

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15
Q

what is hypertrophic cardiomyopathy

A

autosomal dominant genetic disorder

increase heart muscle size and mass

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16
Q

is hypertrophic cardiomyopathy a systolic or diastolic dysfunction

A

diastolic from L ventricle stiffness

decrease ventricle filling = decrease CO (especially during exertion)

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17
Q

when is hypertrophic cardiomyopathy usually dx

A

young adults and athletic individuals

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18
Q

what is the most common cause of death in otherwise healthy individuals

A

hypertrophic cardiomyopathy

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19
Q

what is restrictive cardiomyopathy

A

diastolic dysfunction caused by rigid ventricular walls that impair diastolic filling and ventricular stretch

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20
Q

what are the 4 types of restrictive cardiomyopathy

A

infiltrative disease
storage disease
non-infiltrative
endomyocardial

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21
Q

causes of restrictive cardiomyopathy

A

myocardial fibrosis
hypertrophy
amyloidosis
endocardial fibrosis
radiation to throax

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22
Q

generalized s/sx of cardiomyopathy

A

CHF s/sx
CP
palpitations
dizziness
nausea
syncope with exertion

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23
Q

reasons for a heart transplant

A

cardiomyopathy
ischemic heart disease
valve disease
congenital heart defect
rejection of previous heart transplant

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24
Q

most common procedure for heart transplant

A

orthotropic transplantation (bicaval technique)

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25
what occurs with orthotropic transplantation (bicaval technique)
receipients heart is removed, portion of atria is left in place with vena cava and pulmonary veins
26
3 post-transplant drug classes
corticosteroids (prednisone) calcineurin inhibitors (tacrolimus, cyclosporine) antiproliferative (mycophenolate, mofetil, azathioprine, sirolimus)
27
post-transplant medication risk factors
skin, lip cancer weight gain, obesity DM dyslipidemia kidney failure HTN GI disturbances respiratory problems medication toxicity
28
heart transplant complications
HTN risk for osteoporosis infection rejection (quickly - years later)
29
psychosocial issues r/t heart transplant
increase quality of life fear of heart rejection feelings of guilt indebtness to donor
30
can a person experience angina post heart transplant
No d/t to nerve connection
31
are atropin and digoxin effective after a heart transplant
No
32
what does a ventricular assist device (VAD) do
circulates as much blood per minute as the heart can be internal or external
33
what are the 4 types of VAD
pneumatic electric or electromagnetic axial flow centrifugal
34
what is the main concern with VAD
pump thrombus formation
35
what can be used with VAD when the lungs fail to oxygenate
ECMO
36
pulmonary edema is known as
decompensated heart failure
37
what occurs with pulmonary edema
L ventricle fails, blood backs up into lungs
38
does pulmonary edema occur quickly or slowly
can be either quickly is known as flash pulmonary edema
39
s/sx of pulmonary edema
restless anxious sudden SOB sense of suffocation tachypenic with low O2 SAT cyanotic, pale cool, clammy JVD tachycardia confusion increase quantities of foamy sputum
40
what is infective endocarditis (IE)
infection of endotheial surface (endocardium) injury leads to clot formation, infection invades clot, invaded clot continues to expand and concealed by bodies natural defenses
41
IE is commonly caused by which bacterias
staph strep
42
s/sx of IE
fever, chills weakness, malaise, fatigue anorexia, weight loss abdominal discomfort clubbing HA arthralgia dyspnea CP sharp LUQ pain, spleenomegaly flank pain, hematuria decrease LOC
43
vascular s/sx of IE
splinter hemorrhages petechia osler nodes janeway lesions roth's spots
44
what are osler nodes
small, painful nodules on pad of fingers, toes
45
what are janeway lesions
irregular, red or purple, painless flat macules on palms, fingers, hands, soles, toes
46
what are roth's spots
hemorrhage with pale centers causes by emboli observed in fundi of eye
47
what s/sx to monitor for with IE
s/sx of stroke
48
to Dx IE, pt must have 2+ of which 3 tests
2 positive blood cultures 12 hours apart intracardial mass, vegetation on echo TEE
49
what is needed prior to dental procedures to prevent IE after a heart transplant
prophylactic abx
50
what is myocarditis
inflammation of myocardium
51
what can causes myocarditis
viral, bacterial infections fungi radiation induced chemical, pharmacological agents
52
what is the most common cause of myocarditis
coxsackie A & B virus
53
early s/sx of myocarditis
fever fatigue, malaise pharyngitis dyspnea N/V lymphadenopathy
54
what occurs with myocarditis 7-10 days after viral infection
effusion pericardial friction rub
55
late s/sx of myocarditis
CHF JVD S3 syncope angina peripheral edema
56
only definitive way to Dx myocarditis
MRI
57
other ways to Dx myocarditis
EKG with ST changes elevated WBC, CRP, ESR
58
myocarditis treatment
abx limit physical activity TED hose
59
Can a person with myocarditis take NSAIDS
No
60
what to monitor for if a person has myocarditis and takes digoxin
digitalis toxicity new arrhythmia, A/N/V, HA, malaise
61
what is pericarditis
pericardial inflammation
62
what is the cause of pericarditis
unknown but may be viral, bacterial, or fungal
63
when does acute pericarditis occur
48-72 hours post MI
64
what occurs with acute pericarditis
sac inflamed > leaks fluid (pericardial effusion)
65
what is Dressler syndrome
pericarditis that occurs 4-6 weeks after MI late pericarditis
66
what test is used to confirm pericarditis
EKG
67
pericarditis s/sx
severe, sharp CP with deep inspiration and lying flat (pain can radiate to neck, L shoulder and upper back) dyspnea pericardial friction rub
68
hallmark s/sx of pericarditis
pericardial friction rub
69
when is pericardial friction rub heard best with pericarditis
holding breath while leaning forward
70
what position is used to relieve pericarditis CP
sitting up, leaning forward
71
pericarditis complications
pericardial effusion cardiac tamponade Becks Triad pulseless paradox
72
what is pulseless paradox
drop in BP by 10 mmHg with inspiration must note the pressure heard on expiraiton
73
pericarditis treatment
pericardiocentesis abx tx underlying cause NSAIDS corticosteroids colchine
74
what occurs with mitral stenosis
decrease blood from from L atrium to L ventricle causes a pressure difference during diastole
75
mitral stenosis put a person at risk for which cardiac dysrhythmia
afib
76
where is a diastolic murmur heard with mitral stenosis - 2 locations
L sternal border R 2nd ICS pt must lean forward and hold breath
77
mitral stenosis s/sx
SOB with exertion loud S1 murmur hemoptysis CP emboli fatigue palpitations hoarseness
78
mitral stenosis treatment
surgical splinting valve replacement inoue technique
79
what is mitral regurgitation
blood from from L ventricle back into L atrium incomplete valve closure during systole
80
what are the 2 types of mitral regurgitation
acute, chronic
81
acute mitral regurgitation can lead to what if left untreated
cardiogenic shock
82
acute mitral regurgitation s/sx
thready pulse cool, clammy extremities
83
chronic mitral regurgitation early vs progressive s/sx
early: fatigue, weak, palpitations, dyspnea progressive: orthopnea, noctural dyspnea, peripheral edema
84
an audible S3 is heard where with chronic mitral regurgitation
apex, sound radiates to axilla
85
what is mitral valve prolapse
leaflet balloon back into atrium during systole
86
most common valve problem
MVP
87
does MVP occur more in women or men
women
88
what test is used to Dx MVP
echo
89
treatment method for MVP
control symptoms avoid alcohol, caffeine, tobacco
90
will a with who has MVP and CP respond to nitrates
No
91
MVP s/sx
commonly asymptomatic fatigue SOB lightheaded, dizzy syncope palpitations
92
what is aortic valve stenosis
obstructive blood flow from L ventricle to aorta during systole
93
aortic valve stenosis can lead to what
L ventricular hypertrophy
94
aortic valve stenosis s/sx
angina syncope DOE HF diminished or prominent S4
95
where is an S4 heard with aortic valve stenosis
R 2nd ICS lean forward, exhale
96
what can occur with progressive aortic stenosis
decrease tissue perfusion pulmonary HTN HF
97
what occurs with atrial regurgitation
back flow of blood into L ventricle from aorta during diastole
98
what is 2 diseases are results of atrial regurgitation
pulmonary HTN R CHF
99
what is a diastolic murmur heard with atrial regurgitaiton
3rd or 4th ICS at LSB
100
what are the causes of acute atrial regurgitation
trauma IE aortic dissection (life threatening emergency)
101
acute atrial regurgitation s/sx
abrupt onset of: CP dyspnea L ventricular failure cardiogenic shock
102
chronic atrial regurgitation s/sx
fatigue DOE orthopnea nocturnal dyspnea water hammer pulse (Corrigan's pulse)
103
what is water hammer pulse (Corrigan's pulse)
bounding, forceful pulse with rapid upstroke and descent
104
which artificial valve last longer: mechanical or biological
mechanical
105
which artificial valve requires lifelong anticoagulation therapy: mechanical or biological
mechanical
106
how long can a biological valve last
7-15 years
107
what are the 4 types of biological valves
bovine (cow) porcine (pig) equine (horse) homograft/allograft (cadaver)

M/S 3 (17 decks)

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